在不列颠哥伦比亚省实施药品替代品的毒性药物供应:混合方法研究研究
Bernadette Bernie Pauly1, Megan Kurz2, Laura M Dale2
1Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada; University of Victoria School of Nursing, Box 1700 Stn CSC, Victoria, BC 250, Canada.
Journal of substance use and addiction treatment
|March 15, 2024
概括
在不列颠哥伦比亚省,针对更安全的供应处方的风险减轻指南 (RMG) 接受度有限,特别是在城市地区以外. 实施面临系统性障碍,突出需要更好的支持和基础设施.
科学领域:
- 公共卫生 公共卫生
- 药物使用障碍 药物使用障碍
- 卫生政策 卫生政策
背景情况:
- 北美面临着长期的过量危机,不列颠哥伦比亚省在2016年宣布公共卫生紧急情况.
- 风险减轻指南 (RMG) 于2020年3月实施,旨在为有毒药物供应提供更安全的替代品,旨在减少在双重公共卫生紧急情况 (COVID-19和过量) 期间的危害.
研究的目的:
- 描述在不列颠哥伦比亚省的医疗保健处方者中早期实施风险减轻指导 (RMG).
- 确定RMG采用的障碍和促进因素,以实现更安全的供应处方.
主要方法:
- 一项融合混合方法研究,结合了人口层面相关的行政健康数据与17名处方医生的定性访谈.
- 利用七个链接的数据库和实施研究综合框架 (CFIR) 来分析处方者特征和实施因素.
- 采用单变量总结统计,逻辑回归和解释性描述方法来进行数据分析.
主要成果:
- 在大型城市中心之外观察到RMG的吸收有限,并确定了城市处方者的特定形状.
- 执业护士比全科医生处方RMG的可能性是全科医生的三倍.
- 定性调查结果显示,RMG是有用的,但有争议的,挑战包括支持,资源和基础设施不足,尽管被视为护理的新机会.
结论:
- 在不列颠哥伦比亚省,RMG的实施受到范围,处方者参与和地理范围的限制.
- 系统,组织和个人因素影响了实施,强调需要与监管学院和强有力的规划进行接触.
- 有效的实施和上下文适应需要改进的组织基础设施和支持系统.
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